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Updated: Jun 28, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Intracellular dark endothelial spots detected using specular microscopy are associated with graft failure after
Ami Igarashi1, Masato Takeda2, Naoko Mashiko3
1Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
Purpose:
To investigate the correlation between intracellular dark endothelial spots (IDESs) detected by specular microscopy and the incidence of graft failure after Descemet's membrane endothelial keratoplasty (DMEK).
Methods:
We reviewed 100 consecutive DMEK patients performed by a single surgeon at two centres between January 2015 and July 2022. Central corneal thickness was evaluated using anterior segment optical coherence tomography (SS-1000; Tomey, Aichi, Japan), and endothelial cell density was measured using specular microscopy. Kaplan-Meier estimates and Cox regression models were used to evaluate graft failure and associated risk factors.
Results:
Of the 97 eyes included, 9 experienced graft failure within the follow-up period (52.9 ± 23.9 months). IDES presence significantly correlated with decreased endothelial cell density and higher graft failure rates (hazard ratio = 4.68, 95% confidence interval = [0.96, 22.7], P = 0.034).
Conclusion:
IDESs represent a significant risk factor for graft failure post-DMEK. Careful postoperative management is imperative to minimise this risk.
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